Provider Demographics
NPI:1902866551
Name:CASHER, JP BLAKE (DO)
Entity Type:Individual
Prefix:DR
First Name:JP
Middle Name:BLAKE
Last Name:CASHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4572 SOUTH HAGADORN
Mailing Address - Street 2:2A EAST
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5355
Mailing Address - Country:US
Mailing Address - Phone:517-349-8388
Mailing Address - Fax:517-349-1560
Practice Address - Street 1:4572 SOUTH HAGADORN
Practice Address - Street 2:2A EAST
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5355
Practice Address - Country:US
Practice Address - Phone:517-349-8388
Practice Address - Fax:517-349-1560
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI0091862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI112584660Medicaid
P59290OtherMAGELLAN
036121OtherOPTIONS
1500006OtherUNITED BEHAVIORAL HEALTH
2753300754OtherBCBS
5330075Medicare ID - Type Unspecified
1500006OtherUNITED BEHAVIORAL HEALTH